What’s
in a word? Well, not a lot it would seem, if New Zealand’s experience dealing
with Covid-19 is any guide. Words now seem apparently to have no definitive
meaning, but rather mean that just what those uttering them imagined them to mean
at the time. Just like Humpty Dumpty said to Alice, “When I use a word it
means just what I choose it to mean—neither more
nor less.”
On 25 March the
Prime Minister announced the Level 4 lockdown to Parliament, explaining that
its purpose was to “manage the spread of the COVID-19 epidemic within New
Zealand” because “there was early evidence of
community transmission of COVID-19.” Hence the accompanying “Go hard, go early”
slogan and the “flattening the curve” tag-line.
Two weeks into the lockdown, on 9 April, just
before the Easter weekend, the Prime Minister was talking about breaking the
“chain of transmission”, and, consistent with the earlier comments, about
managing the spread, noting that with just 29 new cases reported that day “we
(were) turning a corner.” She described the campaign as a marathon, but then,
in a phrase which has come to be problematic, added that the aim was to keep
“eliminating” the virus from New Zealand.
That appeared to be a significant step-up from
the earlier ambition of “flattening the curve”. This was at a time when more
and more people were starting to be hit hard by the economic consequences of
the lockdown, and the calls upon the government’s substantial assistance
subsidies and assistance were growing daily. Was it just coincidence, or had there
been a conscious decision based on the clear success to date that, rather just
trying to manage the spread of Covid-19, New Zealand now had the opportunity to
be bolder and become the first country in the world to eliminate it completely?
If so, had any assessment been done of the economic and social costs of doing
so, and whether it was even a feasible objective, given that at some point New
Zealand would have to reopen its doors to trading partners which might have
adopted a lesser standard?
Debate and speculation about the true nature of
the government’s policy continued for the next couple of weeks while the number
of new cases being identified kept on falling. The reduction was such that
after a one-week extension to Level 4, the Prime Minister was able to announce
a move to the less restrictive Level 3 from 28 April. Foreshadowing that
announcement on 16 April, she observed this was possible because “there are
promising signs our go hard and go early elimination strategy is working and
the lockdown is breaking the chain of community transmission.”
But here is when the fun began. According to the Concise
Oxford Dictionary, eliminate means to “get rid of” without qualification. It is
final and absolute. On that basis, therefore, it was reasonable to assume that
by talking of elimination New Zealand was seeking to get rid of Covid-19, once
and for all. But, again, things are not simple, as the Prime Minister later told
Radio New Zealand that “when I talk about elimination it does not mean
zero cases, it means zero tolerance for cases.” She further explained that “the
idea of Covid being completely gone, that is eradication - so there are
important differences there." (The Concise Oxford Dictionary does not think so – it applies the same “get
rid of” definition to eradication, as it does to elimination.)
While we were working all that out, Professor
Michael Baker, part of the Otago Medical School cabal that seems to have been
driving so much of the policy response to date, joined the fray. He felt that
the coming Level 3 period would be “a good
opportunity to work on the definition of elimination.” Even more helpfully, his colleague Professor Nick Wilson
intervened with his view of how elimination should be defined. According to him
elimination means “no active cases at
all in the country for at least a period of four weeks of extensive testing and
other surveillance systems in place.” In his
mind, elimination is clearly some way off.
When the Prime Minister announced on 27 April
that New Zealand had “currently” eliminated Covid-19 from our shores, it was
not clear whether she was applying the Dictionary’s definition, or her own
redefinition. Alice’s reply to Humpty Dumpty that “the question is whether you can make words
mean so many different things" was starting to appear ever more
relevant.
The mounting confusion was all left for the
Director-General of Health to try and clear up on 28 April. New Zealand had not
yet eliminated the virus, he explained, because “elimination is not a point in time - it's not 'we've got to the
end of alert level 4, we've eliminated it'. It's not something that you can
just say 'done and dusted' - it is an ongoing effort." According to the
Director-General, elimination is something else again. Adopting neither the
Prime Minister’s, nor the Concise Oxford Dictionary’s, nor Professors Baker’s or
Wilson’s definitions, he described elimination as "a small number of cases, a knowledge of
where those cases are coming from and an ability to identify cases early, stamp
them out and maintain strict border restrictions so we're not importing new
cases.”
So, there we have it. New Zealand’s Covid-19
strategy has all along really been about “flattening the curve”, which we have
achieved remarkably well, not about getting rid of Covid-19 after all. The
bigger question now becomes, has it all been worth it? Certainly, in terms of
controlling the spread of Covid-19, the answer must be a resounding yes. However,
as people start to think about picking up the threads of life once more, debate
will intensify about whether the mounting economic and social costs which will
last for years to come have been worth it, or whether a steadier approach such
as Australia’s might have been better for our country in the long term.
But since words apparently now have only the
meaning those using them choose to apply to them, it is probably not worth
getting into that debate!